Members of the American Society of Safety Engineers (ASSE) are concerned about the spread of methicillin-resistant staphylococcus aureaus (MRSA) infections in the workplace. According to the Centers for Disease Control and Prevention (CDC), approximately 126,000 hospitalizations are related to MRSA each year; and 70% of hospital acquired infections are due to antibiotic resistant bacteria such as MRSA, with MRSA infections being one of the strongest and fastest growing.
According to ASSE professional member Aruna Vadgama, RN, MPA, CSP, CPHQ, CPE, COHN-S, SRN, CHRM, MRSA is a type of staph bacteria that is of concern to hospital staff because it is strongly resistant to methicillin and to other modern antibiotics, but it can be treated with several other available antibiotics. Staph lives on human skin and/or in the nasal area and can cause a wide range of illnesses from minor skin infections to life-threatening diseases. Infection can be spread through contact with pus from an infected wound, skin-to-skin contact, as well as from contact with other objects –as staph can exist on surfaces for up to six hours. In hospitals, people with weakened immune systems are more susceptible to staph infections.
“Good hygiene, particularly regular and thorough hand washing, offers the best protection (against infection),” Vadgama wrote in a recent article entitled, “MRSA Infection Control: Best Practices.” “The key to treating any disease and/or illness is early detection, early diagnosis, proper treatment, and follow up.”
MRSA is not always easy to detect. A person may be colonized by MRSA, meaning he or she is infected and carries the disease but shows no symptoms. Vadgama notes that nasal swabs are a good way to detect MRSA infection in people who do not show symptoms, as staph infections are commonly found in the nasal area.
Currently there are no federal regulations or standards in place for preventing staph and MRSA infection in the workplace. However, Vadgama noted that there are recent “incentive-based” models for infection control being put in place. For example, the Center for Medicare Services (CMS) recently published its Condition of Participation Standards and Pay for Performance Standards, effective in 2008. The Pay for Performance standards ensure that healthcare organizations or providers do not get reimbursed for the care, treatment and services related to a situation where a patient acquired an infection and or had an adverse outcome due to medical error.
“The new requirement has raised awareness at the healthcare leadership level to develop systems to manage adverse outcomes and to control infection,” wrote Vadgama. “Initiatives implemented include screening high-risk patients for MRSA admission. High risk patients may be patients transferred from nursing homes or long-term care environments, the homeless, patients with compromised immune systems, cancer patients, dialysis patients and others with chronic illnesses. Before admitting these patients, precautionary isolation placement has been used in certain cases.”
In addition, there are some new state-based initiatives taking place to reduce infection rates. California Governor Arnold Schwarzenegger recently signed two bills into law that require California hospitals to strengthen their efforts at preventing staph outbreaks and to reveal to the public their rates of infection. The first bill requires hospitals to improve their infection control rules and report infection rates to California officials. The second bill increases the public health department’s surveillance efforts on hospitals and requires hospital doctors and other medical professionals to be trained in preventing the spread of infections. Similar state regulations are being considered in several other states.
The Joint Commission, an independent and not-for-profit organization that accredits and certifies more than 15,000 healthcare organizations and programs in the U.S., is also involved in initiatives to reduce infections in hospitals. Reducing infection rates by hand washing was adopted as a Joint Commission National Patient Safety Goals (NPSG) Standard. The CDC also provides information about both hospital-associated MRSA (HA-MRSA) and community-associated MRSA (CA-MRSA) through its National MRSA Educational Initiative. For more information on the CDC MRSA prevention initiative or to learn more about MRSA visit this link.
“Good hand hygiene and overall hygiene are the keys to preventing MRSA and other staph infection,” Vadgama said. Vadgama adds that some best practices to prevent staph infections in hospitals include:
Ask medical history/screening questions;
Wash hands before any task;
Cover pus and use gloves to treat infection;
And, encourage staff members who are ill to stay home.
“MRSA can survive on surfaces, equipment and fabrics, including privacy curtains or garments worn by care providers,” said Vadgama. “To prevent the spread of staph or MRSA in the workplace, which includes healthcare environments and general industry, employers should ensure the availability of adequate facilities and supplies that encourage workers to practice good hygiene; that routine housekeeping in the workplace is followed; and that contaminated equipment and surfaces are cleaned with detergent-based cleaners or Environmental Protection Agency (EPA)-registered disinfectants. A solution of 70% alcohol is very effective in decontaminating and disinfecting MRSA on surfaces. While using the community gym or if you have a gym at your workplace, each individual should disinfect equipment prior to using it to prevent acquiring infectious diseases including staph and MRSA.”